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Multicenter Study
. 2025 Sep 15;232(3):679-690.
doi: 10.1093/infdis/jiaf129.

Clinical Phenotypes and Outcomes Associated With Respiratory Syncytial Virus Infection in Critically Ill Patients: A Retrospective Multicenter Cohort Study in Greater Paris Area Hospitals, 2017-2023

Antoine Gaillet  1   2   3 , Richard Layese  3   4 , Slim Fourati  3   5   6 , Héloise Celante  1   2 , Tài Pham  7   8 , Sarah Benghanem  9 , Armand Mekontso Dessap  1   2   3 , Etienne de Montmollin  10 , Jeoffrey Pirault  11 , Antoine Vieillard-Baron  12 , Eric Maury  13 , Yves Cohen  14 , Maxens Decavèle  15   16 , Muriel Fartoukh  17 , Nicholas Heming  18 , Charles Damoisel  19 , Nadia Oubaya  3   5 , Nicolas de Prost  1   2   3   5 ; Prono-RSV study group of the clinical data warehouse of Greater Paris University Hospitals
Collaborators, Affiliations
Multicenter Study

Clinical Phenotypes and Outcomes Associated With Respiratory Syncytial Virus Infection in Critically Ill Patients: A Retrospective Multicenter Cohort Study in Greater Paris Area Hospitals, 2017-2023

Antoine Gaillet et al. J Infect Dis. .

Abstract

Background: Respiratory syncytial virus (RSV) is one of the deadliest respiratory viruses. There is a need to better identify prognostic factors in RSV-infected patients, particularly those requiring intensive care unit (ICU) admission, with a focus on immunosuppressed patients.

Methods: This was a multicenter, retrospective cohort study of RSV-infected adults hospitalized in 17 ICUs in the Greater Paris area between 1 August 2017 and 1 May 2023. The primary endpoint was all-cause day 30 mortality. Supervised and unsupervised analyses were performed.

Results: During the study, 474 RSV-infected patients were admitted (56% male, mean age 65±17 years, 34% immunosuppressed). Day 30 mortality was 14%. Immunosuppression was linked to mortality (aOR=2.10, 95% CI [1.14;3.80], p=0.035). Cluster analysis identified three groups: (1) immunosuppressed (17%, highest mortality 21%), (2) older with comorbidities (43%, mortality 14%), and (3) younger (37%, lowest mortality 9%).

Conclusions: One-third of ICU patients with RSV infection were immunosuppressed, and both supervised and unsupervised methods linked immunosuppression to day 30 mortality. Anti-RSV therapies preventing ICU admission should be evaluated in this subgroup.

Keywords: RSV; acute respiratory failure; immunosuppression; intensive care unit; respiratory syncytial virus.

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Conflict of interest statement

Potential conflicts of interest. S. F. has served as a speaker for GlaxoSmithKline, AstraZeneca, MSD, Pfizer, Cepheid, and Moderna. N. d. P. has served as an advisor or speaker for Moderna and AstraZeneca. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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